[Outcome of Photoselective Vaporizaion of the Prostate with 180 W Greenlight XPS™ System for Treatment of Large Prostatic Hyperplasia of at Least 100 Ml].

We report the outcome of photoselective vaporizaion of the prostate (PVP) with the 180W GreenLight XPS™ system (180 W-XPS) for large benign prostatic hyperplasia (BPH) with a prostate volume of ≥100 ml, in comparison with that with the 120 W GreenLight HPS™ system (120 W-HPS). We studied the outcomes of 86 patients who underwent PVP with 180 W-XPS for BPH with a prostate volume of ≥100 ml between February 2019 and October 2021, in comparison with those of 86 patients who underwent PVP with 120 W-HPS. 180 W-XPS significantly improved postoperative international prostate specific score, quality of life score, overactive bladder symptom score, Qmax, and residual urine volume. The operative time was significantly shorter in 180 W-XPS {100.5 min (150-175)}, than in 120 W-HPS {117.5 min (18-189)}, p＜ 0.05), the laser irradiation time was significantly shorter in 180 W-XPS {63.0 min (35-83)}, than in 120 WHPS : {79. 0 min (24-102)} (p ＜0. 05), and the laser fluence was significantly higher in 180 W-XPS {633647J (291991-805011)}, than in 120 W-HPS {396832J (40000-481842)} (p＜0. 05). At 3 and 12 months postoperatively, the prostate volume reduction rates were 59.8 and 66.7%, respectively, for the 180 W-XPS patients which were rates significantly higher than those for the 120 W-HPS patients, 49.5 and 45.0%, respectively. The PSA reduction rates were 58.1 and 53.2％, respectively, which were significantly higher rates than those for the 120 W-HPS patients, 41.3 and 25.7％, respectively. The 180 W-XPS system was considered to be a more effective and efficient treatment than the 120 W-HPS.

KEGG for taxonomy-based analysis of pathways and genomes.

KEGG (https://www.kegg.jp) is a manually curated database resource integrating various biological objects categorized into systems, genomic, chemical and health information. Each object (database entry) is identified by the KEGG identifier (kid), which generally takes the form of a prefix followed by a five-digit number, and can be retrieved by appending /entry/kid in the URL. The KEGG pathway map viewer, the Brite hierarchy viewer and the newly released KEGG genome browser can be launched by appending /pathway/kid, /brite/kid and /genome/kid, respectively, in the URL. Together with an improved annotation procedure for KO (KEGG Orthology) assignment, an increasing number of eukaryotic genomes have been included in KEGG for better representation of organisms in the taxonomic tree. Multiple taxonomy files are generated for classification of KEGG organisms and viruses, and the Brite hierarchy viewer is used for taxonomy mapping, a variant of Brite mapping in the new KEGG Mapper suite. The taxonomy mapping enables analysis of, for example, how functional links of genes in the pathway and physical links of genes on the chromosome are conserved among organism groups.

[Initial Experience with 180W-XPS Photoselective Vaporization of the Prostate (PVP) for Benign Prostatic Hyperplasia].

We analyzed the perioperative parameters, postoperative urinary status, and complications of 200 patients who underwent photoselective vaporization of the prostate (PVP) with the 180W-X-ray photoelectron spectroscopy (XPS) for benign prostatic hyperplasia at our hospital. In addition, we compared perioperative parameters and complications, as well as the rate of decrease in prostate-specific antigen (PSA) and prostate volume at 3 and 12 months after surgery, with those of the last 200 patients who underwent PVP with the 120W-high-performance system (HPS). The results showed significant differences between methods in operative time (XPS: 67.9±29.0 minutes, HPS: 95.2±32.1 minutes, p＜0.05), laser exposure time (XPS: 41.4±17.8 minutes, HPS: 60.1±19.7 minutes, p＜0.05), and laser dose (XPS: 385,937±180,872, HPS: 300,316±105,528, p＜0.05). In addition, there were significant differences in the rates of decrease in PSA and prostate volume in the 180W-XPS group compared with the 120W-HPS group. The transpiration efficiency of the 180W-XPS was higher than that of the 120W-HPS.

Altered microbiota by a high-fat diet accelerates lethal myeloid hematopoiesis associated with systemic SOCS3 deficiency.

The suppressors of cytokine signaling (SOCS) proteins are negative regulators of cytokine signaling required to prevent excessive cellular responses. In particular, SOCS3 is involved in the regulation of metabolic syndromes, such as obesity and diabetes, by suppressing leptin and insulin signals. SOCS3 also suppresses the inflammatory response associated with metabolic stress, but this specific role remains undefined. Wild-type mice on a high-fat diet (HFD) exhibited only fatty liver, whereas systemic deletion of SOCS3 resulted in excessive myeloid hematopoiesis and hepatic inflammation. In addition, depletion of the gut microbiota resulted in considerable improvement in excess granulopoiesis and splenomegaly, halting the progression of systemic inflammation in SOCS3KO mice on the HFD. This result suggests that intestinal dysbiosis is involved in inflammation associated with SOCS3KO. Although contributing to diet-induced obesity and fatty liver, SOCS3 is nevertheless critical to suppress excess myeloid hematopoiesis and severe systemic inflammation associated with intestinal dysbiosis on HFD.

Osteoclastogenic Potential of Tissue-Engineered Periosteal Sheet: Effects of Culture Media on the Ability to Recruit Osteoclast Precursors.

Cell culture media influence the characteristics of human osteogenic periosteal sheets. We have previously found that a stem cell medium facilitates growth and collagen matrix formation in vitro and osteogenesis in vivo. However, it has not yet been demonstrated which culture medium is superior for osteoclastogenesis, a prerequisite for reconstruction of normal bone metabolic basis. To address this question, we compared chemotaxis and osteoclastogenesis in tissue-engineered periosteal sheets (TPSs) prepared with two types of culture media. Periosteal tissues obtained from adult volunteers were expanded with the conventional Medium 199 or with the stem cell medium, MesenPRO. Hematopoietic enhanced-green-fluorescent-protein (EGFP)-nude mice were prepared by γ-irradiation of Balb/c nu/nu mice and subsequent transplantation of bone marrow cells from CAG-EGFP C57BL/6 mice. TPSs were implanted subcutaneously into the chimeric mice and retrieved after intervals for immunohistopathological examination. EGFP+ cells were similarly recruited to the implantation site in both the TPSs prepared, whereas the distribution of CD11b+ cells was significantly lower in the TPS prepared with the stem cell medium. Instead, osteoclastogenesis was higher in the TPS prepared with the stem cell medium than in the one prepared with the conventional medium. These findings suggest that the stem cell medium is preferable for the preparation of more functional TPSs.

KEGG: integrating viruses and cellular organisms.

KEGG (https://www.kegg.jp/) is a manually curated resource integrating eighteen databases categorized into systems, genomic, chemical and health information. It also provides KEGG mapping tools, which enable understanding of cellular and organism-level functions from genome sequences and other molecular datasets. KEGG mapping is a predictive method of reconstructing molecular network systems from molecular building blocks based on the concept of functional orthologs. Since the introduction of the KEGG NETWORK database, various diseases have been associated with network variants, which are perturbed molecular networks caused by human gene variants, viruses, other pathogens and environmental factors. The network variation maps are created as aligned sets of related networks showing, for example, how different viruses inhibit or activate specific cellular signaling pathways. The KEGG pathway maps are now integrated with network variation maps in the NETWORK database, as well as with conserved functional units of KEGG modules and reaction modules in the MODULE database. The KO database for functional orthologs continues to be improved and virus KOs are being expanded for better understanding of virus-cell interactions and for enabling prediction of viral perturbations.

Transgenic rice overproducing Rubisco exhibits increased yields with improved nitrogen-use efficiency in an experimental paddy field.

The green revolution's breeding of semi-dwarf rice cultivars in the 1960s improved crop yields, with large increases in the use of nitrogen (N) fertilizer. However, excess N application has caused serious environmental problems, including acid rain and the eutrophication of rivers and oceans. To use N to improve crop yields, while minimizing the associated environmental costs, there is a need to produce crops with higher N-use efficiency and higher yield components. Here we show that transgenic rice overproducing ribulose 1,5-bisphosphate carboxylase-oxygenase (Rubisco)-the key enzyme of photosynthesis-exhibits increased yields with improved N-use efficiency for increasing biomass production when receiving sufficient N fertilization in an experimental paddy field. This field experiment demonstrates an improvement in photosynthesis linked to yield increase due to a higher N-use efficiency in a major crop.

Ultrafast Unbalanced Electron Distributions in Quasicrystalline 30° Twisted Bilayer Graphene.

Ultrafast carrier dynamics in a graphene system are very important in terms of optoelectronic devices. Recently, a twisted bilayer graphene has been discovered that possesses interesting electronic properties owing to strong modifications in interlayer couplings. Thus, a better understanding of ultrafast carrier dynamics in a twisted bilayer graphene is highly desired. Here, we reveal the unbalanced electron distributions in a quasicrystalline 30° twisted bilayer graphene (QCTBG), using time- and angle-resolved photoemission spectroscopy on the femtosecond time scale. We distinguish time-dependent electronic behavior between the upper- and lower-layer Dirac cones and gain insight into the dynamical properties of replica bands, which show characteristic signatures due to Umklapp scatterings. The experimental results are reproduced by solving a set of rate equations among the graphene layers and substrate. We find that the substrate buffer layer plays a key role in initial carrier injections to the upper and lower layers. Our results demonstrate that QCTBG can be a promising element for future devices.

Changes in the Pneumococcal Vaccine Serotypes in Adult Noninvasive Pneumonia after the Introduction of Pneumococcal Conjugate Vaccination for Children.

CONTEXT: Although the incidence of invasive pneumococcal infections in children has decreased since the introduction of pneumococcal conjugate vaccines (PCVs), the appearance of serotype replacements has continued to increase. AIMS: We examined the frequency of serotype replacements in adult cases of pneumococcal pneumonia. Furthermore, the transition in the coverage of vaccine serotypes (VTs) to non-VTs (NVTs) was also examined. SETTINGS AND DESIGN: We investigated all confirmed cases of pneumococcal pneumonia in 303 adult patients admitted to Yamagata Saisei Hospital between April 2006 and March 2015. MATERIALS AND METHODS: Pneumococcal serotypes were determined by testing for a specific type of antiserum using the capsular swelling method. STATISTICAL ANALYSIS USED: Chi-square tests were used to compare patient characteristics. RESULTS: Annually, the number of admitted patients ranged from 24 to 43, with most of them being men (64.7% of the total patient cohort). Although many cases involved some underlying conditions, the rate of pneumococcal vaccination remained low. The average rate of multigeneration housing was high (37.6%). The rates of pneumococcal vaccine coverage declined since 2013 (7-valent PCV (PCV7), 18.5%; PCV13, 59.3%; and 23-pneumococcal polysaccharide vaccine (PPSV23), 66.7%) and were <50% for each vaccine (PCV7, 4.7%; PCV13, 32.6%; and PPSV23, 48.8%) in 2015. In addition, the VTs were replaced with NVTs in 2015 (48.8% vs. 51.2%). CONCLUSIONS: The frequency of NVTs in adult pneumococcal pneumonia increased in 2013, with the frequency exceeding that of the vaccine forms in 2015. Regular PCV vaccination of children and multigeneration housing seem to be associated with this reversed trend.

Platelet-Rich Fibrin Extract: A Promising Fetal Bovine Serum Alternative in Explant Cultures of Human Periosteal Sheets for Regenerative Therapy.

In 2004, we developed autologous periosteal sheets for the treatment of periodontal bone defects. This regenerative therapy has successfully regenerated periodontal bone and augmented alveolar ridge for implant placement. However, the necessity for 6-week culture is a limitation. Here, we examined the applicability of a human platelet-rich fibrin extract (PRFext) as an alternative to fetal bovine serum (FBS) for the explant culture of periosteal sheets in a novel culture medium (MSC-PCM) originally developed for maintaining mesenchymal stem cells. Small periosteum tissue segments were expanded in MSC-PCM + 2% PRFext for 4 weeks, and the resulting periosteal sheets were compared with those prepared by the conventional method using Medium199 + 10% FBS for their growth rate, cell multilayer formation, alkaline phosphatase (ALP) activity, and surface antigen expression (CD73, CD90, and CD105). Periosteal sheets grew faster in the novel culture medium than in the conventional medium. However, assessment of cell shape and ALP activity revealed that the periosteal cells growing in the novel medium were relatively immature. These findings suggest that the novel culture medium featuring PRFext offers advantages by shortening the culture period and excluding possible risks associated with xeno-factors without negatively altering the activity of periosteal sheets.

Protease-activated receptor 2 exacerbates cisplatin-induced nephrotoxicity.

Acute kidney injury (AKI) is associated with hypercoagulability. Tissue factor/factor VIIa complex and factor Xa in the coagulation cascade activate protease-activated receptor 2 (PAR2). Previously, we have shown that PAR2-mediated inflammation aggravates kidney injury in models of diabetic kidney disease and adenine-induced renal fibrosis. However, the role of PAR2 in AKI remains unclear. To clarify the role of PAR2, we administered cisplatin, one of the most common causal factors of AKI, to wild-type and PAR2-deficient mice. The expression levels of tissue factor and PAR2 were significantly increased in the kidneys of mice that were administered cisplatin. A lack of PAR2 corrected the levels of plasma blood urea nitrogen and creatinine as well as ameliorated the acute tubular injury score in the kidney. A lack of PAR2 corrected the infiltration of neutrophils and the gene expression levels of proinflammatory cytokines/chemokines in these mouse kidneys. Similarly, apoptotic markers, such as cleaved caspase-3-positive area and Bax/Bcl2 ratio, were attenuated via PAR2 deletion. Thus, elevated PAR2 exacerbates cisplatin nephrotoxicity, and targeting PAR2 is a novel therapeutic option that aids in the treatment of patients with cisplatin-induced AKI.

Photo-induced semimetallic states realised in electron-hole coupled insulators.

Using light to manipulate materials into desired states is one of the goals in condensed matter physics, since light control can provide ultrafast and environmentally friendly photonics devices. However, it is generally difficult to realise a photo-induced phase which is not merely a higher entropy phase corresponding to a high-temperature phase at equilibrium. Here, we report realisation of photo-induced insulator-to-metal transitions in Ta2Ni(Se1-xSx)5 including the excitonic insulator phase using time- and angle-resolved photoemission spectroscopy. From the dynamic properties of the system, we determine that screening of excitonic correlations plays a key role in the timescale of the transition to the metallic phase, which supports the existence of an excitonic insulator phase at equilibrium. The non-equilibrium metallic state observed unexpectedly in the direct-gap excitonic insulator opens up a new avenue to optical band engineering in electron-hole coupled systems.

A case of pneumonia caused by Legionella pneumophila serogroup 12 and treated successfully with imipenem.

The patient was an 83-year-old man hospitalized for Haemophilus influenzae pneumonia, who developed recurrent pneumonia after improvement of the initial episode. Legionella pneumophila serogroup 12 was isolated from the sputum, accompanied by increased serum antibody titers to L. pneumophila serogroup 12. Therefore, the patient was diagnosed as having Legionella pneumonia caused by L. pneumophila serogroup 12. Case reports of pneumonia caused by L. pneumophila serogroup 12 are rare, and the case described herein is the first report of clinical isolation of this organism in Japan. When the genotype was determined by the protocol of The European Working Group for Legionella Infections (Sequence-Based Typing [SBT] for epidemiological typing of L. pneumophila, Version 3.1), the sequence type was ST68. Imipenem/cilastatin therapy was found to be effective for the treatment of Legionella pneumonia in this patient.

Immunoglobulin G4-related lung disease accompanied by organizing pneumonia.

The full picture of immunoglobulin G4-related lung disease (IgG4-RLD) has not yet been elucidated. A 69-year-old man was referred to us with a more than 2-week history of productive cough and fatigue. Chest CT showed an airspace consolidation along the bronchovascular bundles. The pathological findings that were obtained from an open-lung biopsy showed both organizing pneumonia and interstitial pneumonia. Based on the established, comprehensive diagnostic criteria for IgG4-related disease (RD) as of 2011, this patient was given a definitive diagnosis of IgG4-RD. A further accumulation and analysis of those cases that concomitantly present with both IgG4-RLD and organizing pneumonia, like our patient, may contribute to the elucidation of the pathology of IgG4-RLD and the establishment of the disease spectrum.

Relapsing polychondritis complicated by giant cell myocarditis and myositis.

An 83-year-old man presented with a three-week history of dyspnea. The clinical features suggested a diagnosis of relapsing polychondritis (RP); however, the patient died of heart failure. An autopsy revealed active chondritis of the tracheal and bronchial cartilage. Furthermore, giant cell myocarditis (GCM) and myositis were detected. To the best of our knowledge, this represents the first report of RP complicated by GCM and myositis. In patients with RP, GCM and myositis, CD163-positive macrophages and T-cells are most common, and the T-cell subset exhibits CD8 predominance. Common mechanisms of tissue damage caused by cytotoxic T-cells are likely to contribute to RP, GCM and myositis.

Bisphenol A and estrone-induced developmental effects in early chick embryos.

Endocrine disruptors, especially estrogenic substances, are thought to affect the reproduction and development of animals, including humans. We therefore assessed whether bisphenol A (BPA) or estrone (E1) had any adverse effects on chick embryogenesis. Fertilized eggs of white Leghorns were obtained within 24 h after laying. Embryos were administered 0.1, 1.0, and 10.0 mM BPA, and administered 10, 100 nM, and 1 µM E1, and incubated for 48 h at 37 ± 0.5°C and >80% relative humidity with one rotation per hour. The embryos were excised, fixed in 70% ethanol and viewed under a stereomicroscope. Their morphological abnormalities and numbers of somites were recorded. There were no significant difference in the average number of somites in embryos administered BPA and controls. Abnormal embryogenesis, however, showed dose-related increases caused by BPA and E1.

Pharmacologic modulation of parasympathetic activity in heart failure.

In the congestive heart failure state, autonomic dysregulation involves an increase in sympathetic tone and decrease in parasympathetic tone and is associated with increased mortality. It is possible that augmentation of the parasympathetic nervous system (PNS) with pharmacologic therapy may lead to improved symptoms and/or clinical outcomes. There are several new and established pharmacologic interventions that have been studied for their effect on the PNS, including antagonists of the renin-angiotensin system, beta-adrenergic antagonists, digoxin, and vasodilators. In this review, we discuss the current status of the published literature on pharmacologic influences on the PNS by both conventional and experimental drugs targeting heart failure as well as drugs that more directly influence vagal tone. While these analyses have been largely limited to putative surrogates for clinical outcomes like heart rate variability, and it is often difficult to differentiate between indirect and direct pharmacologic effects on the PNS, significant insight into potential mechanisms of action can be derived. The future evaluation of drugs in development for heart failure treatment should include a careful, scientifically sound exploration of the potential impact of the intervention on PNS activity.

[Spontaneous regression of mucosa-associated lymphoid tissue lymphoma of the lung].

We report a case of mucosa-associated lymphoid tissue (MALT) lymphoma of the lung that regressed spontaneously. An 82-year-old man was referred to our hospital because of an abnormal chest shadow. Chest CT scans showed soft tissue components along the periphery of the left main bronchus. Bronchoscopy showed an edematous and protruding lesion. Pathological findings showed diffuse invasion of small lymphoid cells of B-cell origin in the submucosal layers. These cells formed lymphoepithelial lesions. Southern blot hybridization demonstrated monoclonality and immunoglobulin heavy-chain gene rearrangement. We diagnosed MALT lymphoma of the lung. Spontaneous regression was found clinically 16 days after the first tumor biopsy for diagnosis by bronchoscopy. Autofluorescence imaging (AFI) 8 months after the first biopsy showed a decrease in magenta color. Immunohistochemical staining showed marked decrease in CD20 + B cells and an increase in the proportion of T cells, the majority of which were CD4 + T cells. No relapse of these lesions was detected 20 months after the first visit. It may be possible to closely follow up pulmonary MALT lymphoma without immediate treatment.

Isoprenaline increases the slopes of restitution trajectory in the conscious rabbit with ischemic heart failure.

Roughly speaking, restitution is the dependence of recovery time of cardiac electrical activity on heart rate. Increased restitution slope is theorized to be predictive of sudden death after heart injury such as from coronary artery occlusion (ischemia). Adrenaline analogs are known to increase restitution slope in normal hearts, but their effects in failing hearts are unknown. Twenty-six rabbits underwent coronary ligation (n = 15) or sham surgery (n = 11) and implantation of a lead in the heart for recording electrocardiograms. Eight weeks later, unanesthetized rabbits were given 0.25-2.0 ml of 1 µmol/L isoprenaline intravenously, which increased heart rate. Heart rate was quantified by time between QRS peaks (RR) and heart activity duration by R to T peak time (QTp). Ligated rabbits (n = 6) had lower ejection fraction than sham rabbits (n = 7, p < 0.0001) indicative of heart failure, but similar baseline RR (269 ± 15 vs 292 ± 23 ms, p = 0.07), QTp (104 ± 17 vs 91 ± 9 ms, p = 0.1), and isoprenaline-induced minimum RR (204 ± 11 vs 208 ± 6 ms, p = 0.4). The trajectory of QTp vs TQ plots displayed hysteresis and regions of negative slope. The slope of the positive slope region was >1 in ligated rabbits (1.27 ± 0.66) and <1 in sham rabbits (0.35 ± 0.14, p = 0.004). The absolute value of the negative slope was greater in ligated rabbits (- 0.81 ± 0.52 vs - 0.35 ± 0.14, p = 0.04). Isoprenaline increased heart rate and slopes of restitution trajectory in failing hearts. The dynamics of restitution trajectory may hold clues for sudden death in heart failure patients.